Abstract

Objective: Immunosuppressive drugs, antimicrobial agents and infectious complications may cause liver function
test abnormalities (LFTA) in kidney transplant recipients (KTR). The objectives of this study were to identify the
outcome of (LFTA). To identify the risk factors affecting development and severity of hepatotoxicity in KTR.
Methods: We retrospectively evaluated the medical records of KTR. Hepatotoxicity attacks were defined as
impairment in liver function tests that was responsive to drug dose reduction or discontinuation, or treatment of
specific causes such as infectious complications. Results: One hundred-fifty-six episodes of hepatotoxicity
occurred in 107 patients in 281 KTR, with an incidence of 38%. Patients with hepatotoxicity episodes had a high
total mortality rate, higher incidence of positive pre-transplant cytomegalovirus (CMV) IgM test, higher creatinine
values during the first month post-transplant, underwent additional acute rejection episodes, and received fewer
cyclosporin A based ID. Only positive CMV IgM testing was identified as a significant independent risk factor for
hepatotoxicity in our multiple analysis Mycophenolatemofetil (MMF) related hepatotoxicity was the most common
cause of drug related LFTA. Conclusions: Patients with LFTA can have significant complications. Pre-transplant
positive CMV IgM tests predispose transplant recipients to the development of LFTA during the post-transplant
period. MMF can be a serious hepatotoxic drug.